How much rates vary
Facilitymedian $4,365 · 10th to 90th $871 to $8,511Professionalmedian $851 · 10th to 90th $617 to $1,413
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,778.28 Median $5,248.07 Typical High $10,964.78 | Facility | None | $1,778.28 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $616.60 Typical High $933.25 | Professional | None | $588.84 | $616.60 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $5,248.07 Typical High $9,332.54 | Facility | None | $3,715.35 | $5,248.07 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,023.29 Typical High $1,513.56 | Professional | None | $707.95 | $1,023.29 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,318.26 Typical High $2,691.53 | Facility | None | $691.83 | $1,318.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,047.13 | Professional | None | $575.44 | $741.31 | $1,047.13 |
Denver HMP Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $1,380.38 | Facility | None | $588.84 | $758.58 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,230.27 | Professional | None | $616.60 | $831.76 | $1,230.27 |
Select Health Setting Facility Modifier None Typical Low $616.60 Median $1,230.27 Typical High $1,445.44 | Facility | None | $616.60 | $1,230.27 | $1,445.44 |
Select Health Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $933.25 | Professional | None | $602.56 | $630.96 | $933.25 |
United Setting Facility Modifier None Typical Low $676.08 Median $1,412.54 Typical High $5,011.87 | Facility | None | $676.08 | $1,412.54 | $5,011.87 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,202.26 | Professional | None | $575.44 | $741.31 | $1,202.26 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $426.58 |
Where Colorado sits
The same service costs 5.7 times more in Vermont than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
VT $8,095MD $1,429
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.